高通量血液透析对维持性血液透析患者生存率影响的Meta分析

目的已知在某些特殊人群,高通量血液透析(high flux hemodialysis,HFHD)能改善维持性血液透析(maintenance hemodialysis,MHD)患者生存率。本研究拟分析总体来说,高通量血液透析是否改善MHD患者生存率。方法检索了PubMed/MEDLINE、EMBASE和Cochrane Library电子数据库的HFHD对MHD患者生存率影响的随机对照试验(randomized controlled trials,RCT)和前瞻性对照试验(prospective controlled trials,PCT),使用优势比进行计算。结果3个RCT和2个PCT共3609名患者被纳入本次研究:5个试验均比较了HFHD与低通量血液透析(low flux hemodialysis,LFHD)对患者生存率的影响。与LFHD组相比,HFHD组患者的生存率没有得到改善(固定效应模型,OR=1.20,Z=1.85,P=0.06,I2=68.1%)。HFHD组在患者平均住院率、心血管死亡率方面与LFHD组无明显差异。结论HFHD不能提高MHD患者生存率,不能降低MHD患者平均住院率和心血管死亡率。

The meta analysis of influence of high flux hemodialysis on survival rate of maintenance hemodialysis patients

Objective To evaluate the effect of high-flux hemodialysis （HFHD） in the survival rate of maintenance hemodialysis （MHD） patients. Methods randomized controlled trials （RCT） and prospective controlled trials （PCT） studying the effect of HFHD on survival rate of MHD patients were searched in the Pubmed / Medline, EMBASE, and Cochrane Library electronic databases, then the odds ratio was calculated. Results 3609 patients in 3 RCT and 2 PCT were included in this study： the effect of survival rate was compared in the HFHD and LFHD group. Compared with the LFHD group, the survival rate of HFHD group wash not improved （Fixed effect model, OR =1.20, Z=1.85, P=0.06, P=68.1%）. There were no significant difference of average admission rate and cardivascular mortality rate between HFHD group and LFHD group. Conclusions HFHD may not improve the survival rate of MHD patients, and it may not reduce the average admission rate and cardiovascular mortality rate of MHD patients.